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This information was updated March 16, 2020

The Centers For Disease Control and Prevention (CDC) has issued supplemental medical coding guidelines for encounters and telehealth screenings related to the COVID-19 Coronavirus. These codes are to be used in conjunction with the current ICD-10-CM classification and the ICD-10-CM Official Guidelines for  Coding and Reporting.

The medical codes provided below are intended for use only in encounters related to COVID-19. For conditions unrelated to coronavirus, even if presenting simultaneously with COVID-19 symptoms, follow standard ICD-10-CM protocols. This coding guidance has been developed by the CDC and approved by the National Center for Health Statistics, the American Health Information Management Association, the American Hospital Association, and the Centers for Medicare & Medicaid Services.

Notes:

  • If the COVID-19 encounter is documented as being associated with a respiratory infection, NOS, it would be appropriate to assign code J98.8.
  • The diagnosis code B34.2 for Coronavirus infection, unspecified, is generally not appropriate for the COVID-19 virus, because the cases have universally been respiratory in nature, so the site would not be “unspecified.” 
  • If the encounter is documented as suspected, possible or probable COVID-19, do not assign code B97.29. Instead, assign a code(s) explaining the reason for the encounter (such as fever or Z20.828, confirmed case of exposure to Covid-19). 
  • For cases where there is a concern about possible exposure to COVID-19, but this is ruled out after evaluation, it would be appropriate to assign the code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out.
  • For cases where there is actual exposure to someone who is confirmed to have COVID-19, it would be appropriate to assign the code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.

See the official document from the CDC here for more information.

Contact Advantum Health for more information on how to accurately code EHRs for COVID-19.

For cases confirmed as resulting from COVID-19

NOS=Not Otherwise Specified
Diagnosis ICD-10 Code for Covid-19
Pneumonia   J12.89
Acute Bronchitis   J20.8
Bronchitis (NOS) due to Covid-19   J40
Lower respiratory infection (NOS)   J22
Acute respiratory infection (NOS)  J22
Acute Respiratory Distress Syndrome (ARDS) J80
Confirmed case of exposure to Covid-19 Z20.828

Presenting symptoms without an established, definitive diagnosis

Diagnosis    ICD-10 Code for Covid-19
Cough R05
Shortness Of Breath R06.02
Fever, unspecified  R50.9

Telephone evaluation and management

Codes for Physicians ICD-10 Code for Covid-19
5-10 minute phone call with medical discussion  99441
11-20 minute phone call with medical discussion  99442
21-30 minute phone call with medical discussion   99443
Codes for Physician Extenders (Nurses, NPs, PAs)
5-10 minute phone call with medical discussion 98966
11-20 minute phone call with medical discussion  98967
21-30 minute phone call with medical discussion 98968

Telehealth Codes

Online digital E&M service, for an established patient, for up to 7 days, cumulative time during the 7 days.
Service ICD-10 Code for Covid-19
5-10 minutes of medical discussion 99421
11-20 minutes of medical discussion 99422
21 or more minutes of medical discussion 99423
 See More:
CMS Expands Access to Telehealth Services During COVID-19 Pandemic
CMS Waives Regulations for Healthcare Providers to Combat COVID-19